Kathleen,  Here in Maryland (MD) the medicaid patients have been moved into
Health Maintainance Organizations (HMOs) so we also ran into this problem of
the HMO refusing coverage of breastpumps even when the mother and baby were
separated by hospitalization.  I personally spoke to someone at our state
Medicaid office and he told me the HMOs were obliged by law to offer the
same level of coverage as medicaid, in other words they could not cover LESS
than medicaid had covered prior to moving patients into the HMOs. This was
at the time in MD when the move to HMOs was voluntary although heavily
encouraged.  Now, to my knowledge, there is no option for the patient, they
must go to an HMO.  I don't know if the mandatory change to HMOs changes the
picture.   I'd talk to someone at your state Medicaid office to inquire if
the HMO is obligated to provide a minimum standard of care.  We had to call
the individual HMO offices and point this obligation out to them and then
they demanded we pre authorize prior to the pump rental which has presented
some problems with early discharges.  I'm a bit sheltered from this because
it is in a hospital and we have case managers and a company who does the
rentals.

Carla